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一种基于人工智能的心力衰竭治疗建议系统。

An AI-Based Heart Failure Treatment Adviser System.

作者信息

Chen Zhuo, Salazar Elmer, Marple Kyle, Das Sandeep R, Amin Alpesh, Cheeran Daniel, Tamil Lakshman S, Gupta Gopal

机构信息

Computer Science DepartmentThe University of Texas at DallasRichardsonTX75080USA.

Walmart TechnologyPlanoTX75024USA.

出版信息

IEEE J Transl Eng Health Med. 2018 Nov 23;6:2800810. doi: 10.1109/JTEHM.2018.2883069. eCollection 2018.

Abstract

Management of heart failure is a major health care challenge. Healthcare providers are expected to use best practices described in clinical practice guidelines, which typically consist of a long series of complex rules. For heart failure management, the relevant guidelines are nearly 80 pages long. Due to their complexity, the guidelines are often difficult to fully comply with, which can result in suboptimal medical practices. In this paper, we describe a heart failure treatment adviser system that automates the entire set of rules in the guidelines for heart failure management. The system is based on , a form of declarative programming suited for simulating human-style reasoning. Given a patient's information, the system is able to generate a set of guideline-compliant recommendations. We conducted a pilot study of the system on 21 real and 10 simulated patients with heart failure. The results show that the system can give treatment recommendations compliant with the guidelines. Out of 187 total recommendations made by the system, 176 were agreed upon by the expert cardiologists. Also, the system missed eight valid recommendations. The reason for the missed and discordant recommendations seems to be insufficient information, differing style, experience, and knowledge of experts in decision-making that were not captured in the system at this time. The system can serve as a point-of-care tool for clinics. Also, it can be used as an educational tool for training physicians and an assessment tool to measure the quality metrics of heart failure care of an institution.

摘要

心力衰竭的管理是一项重大的医疗保健挑战。医疗服务提供者应采用临床实践指南中描述的最佳实践方法,这些指南通常包含一长串复杂的规则。对于心力衰竭管理而言,相关指南将近80页。由于其复杂性,这些指南往往难以完全遵循,这可能导致医疗实践效果欠佳。在本文中,我们描述了一种心力衰竭治疗顾问系统,该系统可自动执行心力衰竭管理指南中的整套规则。该系统基于一种声明式编程形式,适用于模拟人类式推理。给定患者信息,该系统能够生成一组符合指南的建议。我们对21名真实心力衰竭患者和10名模拟心力衰竭患者进行了该系统的试点研究。结果表明,该系统能够给出符合指南的治疗建议。在该系统给出的187条建议中,有176条得到了心脏病专家的认可。此外,该系统遗漏了8条有效建议。遗漏和不一致建议的原因似乎是信息不足、专家在决策时的风格、经验和知识存在差异,而这些目前在系统中并未体现。该系统可作为诊所的床边护理工具。此外,它还可作为培训医生的教育工具以及衡量机构心力衰竭护理质量指标的评估工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c10/6286183/875b356aad7b/chen1-2883069.jpg

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